Registration Requirements Form

Use this form to provide us with as much or as little detail as you wish. At a minimum, provide us with your name and telephone number and tell us how you'd like us to work with you on the remaining information using the options at the base of the form.

Pre-Arrangement Details

Personal Information

Full Name of Person For Whom the Arrangements Are Being Made

Street

City

State/Province

ZIP/Postcode

Telephone

Date of Birth

Place of Birth

Social Insurance Number

BC MSP Number (Care Card Number)

Occupation (If retired occupation before retiring)

Field of Business

Number of Years Worked

Spouse's Information is required for applying for CPP Benefits

We require the spouse's name for registration no matter the marital status. The other spousal information is only required if the deceased was still married at the time of death.

Marital Status

MarriedWidowedDivorcedNever MarriedCommon-LawOther

Spouse's Name (including maiden name)

Spouse's Date of Birth

Spouse's Place of Birth

Spouse's SIN #

Date of Marriage

Parent's information is required for registration with Vital Statistics